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November 21, 1966

Monitoring the Blood pH in Acute Myocardial InfarctionThe Role of Acidosis in Arrhythmias

JAMA. 1966;198(8):947-949. doi:10.1001/jama.1966.03110210197055

CLINICIANS recognize the importance of continuous electrocardiographic surveillance in immediately alerting the attending staff of a cardiac catastrophe and in monitoring the various measures designed to restore normal cardiac function.1-3 Ideally, it would be more desirable to identify the earliest recognizable event that might predict a cardiac arrest. The question raised herein is whether the metabolic acidosis observed after a cardiac arrest (ventricular fibrillation or asystole) is solely secondary or whether this also may precede and contribute to the environment that provokes the development of these arrhythmias. If the latter were true, then such monitoring of the pH would be a valuable adjunct to electrical monitoring of the acutely ill patient. This preliminary paper reports our experience with pH monitoring in critically ill patients with acute myocardial infarction complicated by arrhythmias, pulmonary edema, or cardiogenic shock.

Subjects and Methods  Ten patients with acute myocardial infarction were studied in the